TY - JOUR T1 - When to refer patients with advanced COPD to palliative care services JF - Breathe JO - Breathe DO - 10.1183/20734735.0061-2020 VL - 16 IS - 3 SP - 200061 AU - Rebecca Strutt Y1 - 2020/09/01 UR - http://breathe.ersjournals.com/content/16/3/200061.abstract N2 - According to the World Health Organization, the health burden from COPD will increase in the coming decades, due to continued exposure to risk factors, population growth and ageing. It will become the third leading cause of death by 2030 [1]. Globally, there were 3.1 million deaths from the disease in 2015, but in addition, COPD deaths may be underreported. It is common for a comorbidity such as cor pulmonale to be reported as the main cause of death, rather than COPD [2]. More than 90% deaths occur in low- and middle-income families [3]. The causal relationship between COPD and smoking has long been established and accepted. In addition, socioeconomic status affects lung function and respiratory function independently, and its impact is second only to smoking [4]. Therefore, in areas of relative socioeconomic disadvantage, not only will more patients present with COPD, but these patients will have poorer outcomes than patients in higher socioeconomic groups.COPD is a significant health issue around the world. It is ultimately a fatal disease. Patients are under-referred to palliative care. Palliative care can improve breathlessness and provide other psychosocial interventions that can improve quality of life. https://bit.ly/2VQ8FrR ER -